ASHLEY HUGHES
Lithonia
Summary
Experienced in processing and optimizing workflow efficiency, utilizing strong organizational skills and attention to detail to maintain compliance and accuracy. Possess knowledge of data management techniques and quality assurance protocols. Efficient in customer service and claims with a robust background in processing, demonstrating a proven ability to streamline workflows and ensure compliance with regulatory standards. Expertise in data management and quality assurance is clearly demonstrated.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Auto/Property Insurance Claim Processor
Pilot Catastrophe Services
08.2005 - 02.2023
- Communicate with insured regarding the next steps and findings while processing homeowners' insurance claims or auto claims.
- Worked with homeowners, contractors, auto owners, and body shop on request for repairs, ordered inspections and reschedule property inspection.
- Provided quality customer service to insured in a timely order and held responsible for the identification, research, and qualification of auto claims.
Customer Service/ Medical Billing
Trubridge Inc
03.2014 - 10.2015
- Reviewing medical procedures as documented by doctors.
- Translating medical procedures into codes that can be translated by payers, other medical coders, and medical facilities.
- Coordinating insurance reimbursement of care providers.
Customer Service Representative
Alorica Inc
02.2009 - 01.2014
- Resolve customers' service or billing complaints by performing activities such as exchanging merchandise and adjusting bills.
- Assist customers by telephone to provide information about products and services, to cancel or start accounts, or to obtain details of complaints.
- Check to ensure that appropriate changes were made to resolve customers' problems.
Education
High School Diploma -
John L LeFlore High School
05-2005
Skills
- Communication skills
- Live chat
- RECEPTIONIST
- Patient Care
- Insurance Verification
- Call center
- Time management
- Medical Terminology
- Customer Service
- Organizational skills
- Attention to detail
- Teamwork and collaboration
- Customer service
- Data entry experience
Certification
- Mental Health First Aid - National Council for Mental Wellbeing
- CPR & First Aid Certified - American Red Cross
- HIPAA Certified - American Health Information Management Association
Additional Information
Customer Service, Behavioral Health, Member Support, Inbound/Outbound Calling, Mental Health Services, Benefits Explanation, Claims Resolution, Prior Authorization, Crisis De-escalation, HIPAA Compliance, Appointment Scheduling, Case Documentation, Multichannel Support, Conflict Resolution, First Call Resolution, Problem Solving, Patient Advocacy, Attention to Detail, Empathy & Compassion, Service Recovery
Timeline
Customer Service/ Medical Billing
Trubridge Inc
03.2014 - 10.2015
Customer Service Representative
Alorica Inc
02.2009 - 01.2014
Auto/Property Insurance Claim Processor
Pilot Catastrophe Services
08.2005 - 02.2023
High School Diploma -
John L LeFlore High School
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